Background: The BCR-ABL gene encodes an oncoprotein with abnormal tyrosine kinase activity affecting cellular proliferation, survival, and apoptosis, is the cause of chronic myelogenous leukemia (CML). A type of programmed cell death termed apoptosis works as a preventative measure against diseases like cancer.
Objective: This study aimed to assess four apoptotic players in CML patients as an attempt to provide new options for targeted therapy, and to examine these proteins as potential predictors for the disease.
Methods: 140 participants were divided into two groups, healthy controls (CT) and people with chronic myeloid leukemia. Healthy samples were 60, while 80 samples were taken from patients who had been diagnosed with CML in the International Hematology Center, Baghdad, Iraq. Using ELISA approach, we measured serum levels of four critical participants of apoptosis (TNFR1, BAX, CASP-9, and CYTO-C) in CML patients and controls.
Results: In comparison to patients, controls had higher median levels of BAX, CYTO-C, and CASP-9. While median TNFR1 levels in patients were greater than in controls. Age-dependently, CT groups had significantly higher levels of BAX, CYTO-C, and CASP-9 than CML groups in the age categories of < 40 years and 40–50 years, in contrast to TNFR1 which was markedly down regulated in CT. According to gender, CT groups had significantly greater levels of BAX, CYTO-C, and CASP-9 than CML, while TNFR1 was significantly higher in CML than CT groups in both genders. BAX, CYTO-C, TNFR1, and CASP-9 are effective predictors in differentiating between CML patients and CT groups according to the results obtained from receiver operating characteristic analysis. Correlation coefficient analysis test revealed that BAX correlated with CYTO-C and CASP-9 in a positive-significant manner. While BAX had a positive, although insignificant correlation with TNFR1. TNFR1 and CASP-9 had a non-significant positive correlation with CYTO-C. Finally, TNFR1 and CASP-9 showed positive but non-significant correlation.
Conclusions: BAX, CYTO-C, TNFR1, and CASP-9, provide potential targets for diagnosis, prognosis, and treatment. As they turned to be excellent predictors in CML.